李梦娜负责撰写文章，陆丽华负责收集资料，洪叶兰负责收集资料，伍勇负责提出构思及审校论文。
收稿日期: 2025-09-26
修回日期: 2026-05-04
录用日期: 2026-05-06
网络出版日期: 2026-06-27
基金资助
湖南省自然科学基金（青年基金）(2023JJ40066)
Research progress on antibacterial strategies against methicillin-resistant Staphylococcus aureus
Received date: 2025-09-26
Revised date: 2026-05-04
Accepted date: 2026-05-06
Online published: 2026-06-27
耐甲氧西林金黄色葡萄球菌（methicillin-resistant Staphylococcus aureus，MRSA）的院内死亡率可达到20%~30%，已引起了全球关注，但目前临床上针对MRSA感染的治疗手段十分有限。MRSA的耐药机制可分为固有耐药和获得性耐药，固有耐药主要是通过分泌β-内酰胺酶和外排系统的激活实现；MRSA也可以通过基因突变或者含有耐药基因的质粒转化而获得耐药性。此外，生物膜的形成以及小菌落变异体也是其获得耐药性的重要机制。传统抗菌药物仍是目前临床治疗MRSA菌血症的主要手段。随着MRSA对传统抗菌药物的耐受性逐渐增强，对于新型治疗手段的研究也获得了巨大进展，如群体密度感应系统（quorum-sensing system，QS）抑制剂、抗菌肽、小分子化合物、抗菌光动力学疗法、噬菌体疗法以及联合用药等，都在MRSA感染治疗中有着巨大潜力，为临床提供了更高效、低毒和可持续的解决方案，也为探索不同于传统抗菌药物的作用机制的新型抗菌药物提供了新的思路。
关键词： 耐甲氧西林金黄色葡萄球菌; 耐药机制; β-内酰胺酶
李梦娜 , 陆丽华 , 洪叶兰 , 伍勇 . 耐甲氧西林金黄色葡萄球菌抗菌策略研究进展[J]. 诊断学理论与实践, 2026 , 25(03) : 361 -369 . DOI: 10.16150/j.1671-2870.2026.03.013
The in-hospital mortality rate of methicillin-resistant Staphylococcus aureus (MRSA) can reach 20%-30%, which has attracted global attention. However, the clinical treatment options for MRSA infections are still very limited. The drug resistance mechanisms of MRSA can be divided into intrinsic and acquired types. Intrinsic drug resistance is mainly achieved through the secretion of β-lactamase and the activation of efflux pumps. MRSA can acquire drug resistance through gene mutations or plasmid transformation involving drug-resistant genes. Additionally, the formation of biofilms and the emergence of small colony variants are also important mechanisms for acquired drug resistance. In clinical practice, traditional antibiotics are still the main approach for treating MRSA bacteremia. As MRSA tolerance to traditional antibiotics gradually increases, research on new therapeutic methods has also made great progress. Among these, quorum-sensing system (QS) inhibitors, antimicrobial peptides, small-molecule compounds, antimicrobial photodynamic therapy, phage therapy, and combination therapy have shown great potential in the treatment of MRSA infections. These novel approaches not only provide more effective, low-toxicity, and sustainable solutions for clinical practice but also offer new ideas for the exploration of new antibiotics with mechanisms of action different from those of traditional antibiotics.
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